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(Hemorrhoids)

Patient Profile
20 ( 2)
1-2

10 2558
CC: 1-2

HPI: 3

PMH:
SH:
ALL:
SOAP note
Problem: Acute Hemorrhoids
Subjective data:
1-2
3

Objective data: No data


Assessment:
4.4%
[1]

rectum


[2]

(Hemorrhoids)
dentate line
dentate line
dentate line [3]







[2]


4 [3]
1
2
3

4

2

3
( 1 2)

(Hemorrhoids)
1 2 3 4
[4]
1.
-

8-10




15-30 -

2.
-

(proctosedyl ointment, scheriproct-N ointment)



[2]
rutin hesperidine diosmin (daflon, venoruton300,)

3. () [3]
-

(sclerosing agents) 5% phenol in vegetable oil 1% polidocanol


in ethanol
(rubber band ligation)
(infrared photocoagulation)
bipolar coagulation
( 3 4 )

2 (non-pharmacological therapy)
2
-

proctosedyl ointment (Cinchocaine hydrochloride hydrocortisone)


scheriproct-N ointment (flucotolone pivalate lidocaine)

3
-

daflon (90% micronized diosmin 10% hesperidin)

venoruton 300 (0-(beta hydroyethyl)-rutosides)

(Cissus quadrangularis)

(Hemorrhoids)
IESAC
Drug for hemorrhoid Daflon
Venoruton300
Active ingredient
90%
micronized 0- (beta hydroyethyl)
diosmin
10% rutosides
hesperidin
Indication
Hemorrhoid
Hemorrhoid
Efficacy
Daflon Annoni F

,
, [6]
[5]

Safety

Adherence

Cost

Cissus
quadrangularis
Ketosterones

Hemorrhoid
.
Daflon



1 20 5%
Dosage regimen:
1-2g per day in divided [7]
Dosage regimen: 3x3 pc
dose
Nausea,
vomiting, Headache, flatulence, dry
heartburn, epigastric mouth, diarrhea, insomnia
pain
Initial: 300mg 1x3 pc
Dose: 3x3 pc
Maintain: 300mg 1x2 pc

Dosage regimen:
3g for 4 days and 2g for
3 days
Stomach
and
abdominal pain, mild
diarrhea, headache
Initial: 3x2 pc for 4 days
then 2x2 pc for 3 days
Maintain: 1x2 pc
155 (15 tab) 95 (10 tab)

130
(100 capsules)
IESAC
daflon
Plan:
Goal of therapy
-

Therapeutic plan
-

3 3

Monitoring

(Hemorrhoids)
Efficacy:
Safety: Headache, flatulence, dry mouth, diarrhea, insomnia
Patient education
-

Future plan

Reference
1. Johanson JF, Sonnenberg A. The prevalence of hemorrhoids and chronic constipation: an epidemiologic
study. Gastroenterology 1990;98:380386
2. .
1. 2556
3. .
. 2551
4. [][ 15 2558]. (Hemorrhoid).
http://www.msd.bangkok.go.th/healthconner_Hemorrhoid.htm
5. Lyseng-Williamson KA, Perry CM. Micronised purified flavonoid fraction: a review of its use in chronic
venous insufficiency, venous ulcers and haemorrhoids. Drugs. 2003;63(1):71-100.
6. Annoni F, Boccasanta P et al. Treatment of acute symptoms of hemorrhoid disease with high-dose oral
O-(beta-hydroxyethyl)-rutosides. Minerva med 1986; 77(37): 1663-8

(Hemorrhoids)
7. . . : . 2549